JP2021000247A - Electro-surgical tool and cover - Google Patents

Abstract

To provide an electro-surgical tool which allows a user to search for a cover detached in a body of a patient even when a cover is broken in surgical operation and falls in the body of the patient from the electro-surgical tool.SOLUTION: An electro-surgical tool 40 is detachably coupled to a robot arm 21a of a robot surgical system 100. The electro-surgical tool 40 comprises: a shaft 42; an end effector 41 which is provided on a distal end side of the shaft 42 through a wrist structure 45; a coupling part 40a which is provided on a proximal end side of the shaft 42 and coupled to the robot arm 21a; and a cover 46 comprising a hollow elongated structure for storing the wrist structure 45, and including an electric insulation material, and including an X-ray contrast medium.SELECTED DRAWING: Figure 6

Description

The present invention relates to electrosurgical instruments and covers, and in particular to electrosurgical instruments that are detachably connected to a robot arm of a robotic surgery system and covers of the electrosurgical instruments.

Conventionally, an electric surgical instrument that is detachably connected to a robot arm of a robotic surgery system is known (see, for example, Patent Document 1).

Patent Document 1 discloses an electric surgical instrument that is removably connected to a robot manipulator (robot arm) of a robotic surgery system. This electrosurgical instrument has an end effector and a wrist structure for operating the end effector. A part of the end effector and the wrist structure are housed by an electrically insulating cover. This cover is made of silicone, which has excellent flexibility and restoring force.

Special Table 2013-530771

Although the cover described in Patent Document 1 is made of silicone having excellent flexibility and restoring force, the cover may be damaged and fall off in the patient's body during surgery. In this case, there is a problem that the fallen cover cannot be found in the patient's body.

The present invention provides an electrosurgical instrument and a cover that can search for a cover that has fallen off in the patient's body even if the cover is damaged during surgery and falls off in the patient's body. ..

The electrosurgical instrument according to the first aspect of the present invention is an electrosurgical instrument that is detachably connected to a robot arm of a robotic surgery system and is provided on a shaft and on the distal end side of the shaft via a wrist structure. It has an end effector, a connection part provided on the proximal end side of the shaft, a connection part connected to the robot arm, a hollow elongated structure for accommodating the wrist structure, an electrically insulating material, and X-ray imaging. It comprises a cover containing the agent.

As described above, the electrosurgical instrument according to the first aspect of the present invention has a hollow elongated structure for accommodating the wrist structure, and is provided with a cover containing an electrically insulating material and an X-ray contrast agent. .. As a result, the cover containing the X-ray contrast medium can be detected by X-rays, so that even if the cover is damaged during surgery and falls off the patient's body from the electrosurgical instrument, the cover that has fallen off inside the patient's body. We can provide electrosurgical instruments that can be searched for.

The cover according to the second aspect of the present invention is detachably connected to the robot arm of the robotic surgery system, and also includes a shaft, an end effector provided on the distal end side of the shaft via a wrist structure, and a shaft. A cover for an electrosurgical instrument provided on the proximal end side with a connection to connect to a robot arm, which has a hollow elongated structure to accommodate the wrist structure and is an electrically insulating material. And an X-ray contrast agent.

As described above, the cover according to the second aspect of the present invention has a hollow elongated structure for accommodating the wrist structure, and also includes an electrically insulating material and an X-ray contrast agent. As a result, even if the cover is damaged during the operation and falls off from the electrosurgical instrument in the patient's body, it is possible to search for the cover that has fallen off in the patient's body, as in the case of the electrosurgical instrument according to the first aspect. Cover can be provided.

According to the present invention, there is provided an electrosurgical instrument and a cover that can search for a cover that has fallen off in the patient's body even if the cover is damaged during the operation and falls off in the patient's body. Can be done.

It is a figure which showed the outline of the robot operation system by 1st and 2nd Embodiment. It is a block diagram which showed the control structure of the robot operation system by 1st and 2nd Embodiment. It is a perspective view which showed the state which the electric surgical instrument was attached to the drive part of the robot arm by 1st and 2nd Embodiment via an adapter. It is a perspective view which showed the state which removed the adapter and the electric surgical instrument from the drive part of the robot arm by 1st and 2nd Embodiment. It is a perspective view which looked at the adapter and the electric surgical instrument by the 1st and 2nd embodiments from the Z2 direction side. (A) is a diagram showing a state in which the cover of the electric surgical instrument according to the first embodiment is removed, and (B) is a diagram showing a state in which the cover of the electric surgical instrument according to the first embodiment is attached. is there. It is a perspective view which showed the cover of the electric surgical instrument by 1st Embodiment. It is sectional drawing which showed the cover of the electric surgical instrument by 1st Embodiment.

Hereinafter, embodiments will be described with reference to the drawings.

[First Embodiment]
(Structure of robotic surgery system)
The configuration of the robotic surgery system 100 according to the first embodiment will be described with reference to FIGS. 1 and 2.

As shown in FIG. 1, the robotic surgery system 100 includes a remote control device 10 and a patient side device 20. The remote control device 10 is provided for remotely controlling a medical appliance provided in the patient side device 20. When the operation mode command to be executed by the patient-side device 20 is input to the remote control device 10 by the operator O who is a surgeon, the remote control device 10 issues the operation mode command to the patient via the controller 26. It is transmitted to the side device 20. Then, the patient-side device 20 responds to the operation mode command transmitted from the remote control device 10, and responds to the surgical instrument 40 attached to the robot arm 21a and the endoscope 50 attached to the robot arm 21b. Operate medical equipment such as. As a result, minimally invasive surgery is performed.

The patient-side device 20 constitutes an interface for performing surgery on patient P. The patient-side device 20 is placed beside the operating table 30 on which the patient P lies. The patient-side device 20 has a plurality of robot arms 21a and 21b, of which the endoscope 50 is attached to one robot arm 21b and the electrosurgical instrument 40 is attached to the other robot arm 21a. The robot arms 21a and 21b are commonly supported by the platform 23. Each of the plurality of robot arms 21a and 21b has a plurality of joints, and each joint is provided with a drive unit including a servomotor and a position detector such as an encoder. The robot arms 21a and 21b are configured such that the medical device attached to the robot arms 21a and 21b is controlled to perform a desired operation by a drive signal given via the controller 26.

The platform 23 is supported by a positioner 22 placed on the floor of the operating room. In the positioner 22, a pillar portion 24 having an elevating shaft that can be adjusted in the vertical direction is connected to a base 25 that has wheels and can move the floor surface.

An electric surgical instrument 40 as a medical instrument is detachably attached to the tip of the robot arm 21a. The electrosurgical instrument 40 includes a housing 43 (see FIG. 4) attached to the robot arm 21a, an elongated shaft 42 (see FIG. 4), and an end effector 41 (see FIG. 4) provided at the tip of the shaft 42. And have. Examples of the end effector 41 include, but are not limited to, grasping forceps, scissors, hooks, high-frequency knives, snare wires, clamps, and staplers, and various treatment tools can be applied. In the operation using the patient-side device 20, the robot arm 21a introduces the electric surgical instrument 40 into the body of the patient P via a cannula (trocca) placed on the body surface of the patient P. Then, the end effector 41 of the electric surgical instrument 40 is arranged in the vicinity of the surgical site.

An endoscope 50 as a medical instrument is detachably attached to the tip of the robot arm 21b. The endoscope 50 photographs the inside of the body cavity of the patient P, and the captured image is output to the remote control device 10. As the endoscope 50, a 3D endoscope or a 2D endoscope capable of taking a three-dimensional image is used. In the operation using the patient-side device 20, the robot arm 21b introduces the endoscope 50 into the body of the patient P via the trocca placed on the body surface of the patient P. Then, the endoscope 50 is arranged in the vicinity of the surgical site.

The remote control device 10 constitutes an interface with the operator O. The remote control device 10 is a device for the operator O to operate the medical device attached to the robot arms 21a and 21b. That is, the remote control device 10 is configured to be able to transmit an operation mode command to be executed by the electrosurgical instrument 40 and the endoscope 50 input by the operator O to the patient side device 20 via the controller 26. .. The remote control device 10 is installed near the operating table 30 so that the state of the patient P can be clearly seen while operating the master, for example. It should be noted that the remote control device 10 can be installed in a room separate from the operating room in which the operating table 30 is installed, for example, by wirelessly transmitting an operation mode command.

The operation mode to be performed by the electric surgical instrument 40 is an operation mode (a series of positions and postures) of the electric surgical instrument 40 and an operation mode realized by the individual functions of the electric surgical instrument 40. For example, when the electrosurgical instrument 40 is a grasping forceps, the operation modes to be executed by the electrosurgical instrument 40 are the roll rotation position and pitch rotation position of the wrist of the end effector 41 and the operation of opening and closing the jaw. Is. Further, when the electrosurgical instrument 40 is a high-frequency knife, the operation mode to be executed by the electrosurgical instrument 40 may be the vibration operation of the high-frequency knife, specifically, the supply of current to the high-frequency knife. Further, when the electric surgical instrument 40 is a snare wire, the operation mode to be executed by the electric surgical instrument 40 may be a binding operation and a binding state releasing operation. In addition, it may be an operation of burning off the surgical target site by supplying an electric current to a bipolar or monopolar.

The operation mode to be executed by the endoscope 50 is, for example, the position and orientation of the tip of the endoscope 50, or the setting of the zoom magnification.

As shown in FIGS. 1 and 2, the remote control device 10 includes an operation handle 11, an operation pedal unit 12, a display unit 13, and a control device 14.

The operation handle 11 is provided for remotely operating the medical device attached to the robot arms 21a and 21b. Specifically, the operation handle 11 receives an operation by the operator O for operating a medical instrument (electric surgical instrument 40, endoscope 50). Two operation handles 11 are provided along the horizontal direction. That is, one of the two operation handles 11 is operated by the right hand of the operator O, and the other operation handle 11 of the two operation handles 11 is operated by the left hand of the operator O.

Further, the operation handle 11 is arranged so as to extend from the rear side of the remote control device 10 toward the front side. The operation handle 11 is configured to be movable within a predetermined three-dimensional operation area. That is, the operation handle 11 is configured to be movable in the vertical direction, the horizontal direction, and the front-rear direction.

The remote control device 10 and the patient side device 20 form a master-slave type system in controlling the operation of the robot arm 21a and the robot arm 21b. That is, the operation handle 11 constitutes an operation unit on the master side in the master-slave type system, and the robot arm 21a and the robot arm 21b to which the medical device is attached constitute an operation unit on the slave side. Then, when the operator O operates the operation handle 11, the tip of the robot arm 21a (end effector 41 of the electrosurgical instrument 40) or the tip of the robot arm 21b (endoscope 50) traces the movement of the operation handle 11. The operation of the robot arm 21a or the robot arm 21b is controlled so as to move.

Further, the patient-side device 20 is configured to control the operation of the robot arm 21a according to the set operation magnification. For example, when the operating magnification is set to 1/2, the end effector 41 of the electrosurgical instrument 40 is controlled to move a moving distance of 1/2 of the moving distance of the operation handle 11. As a result, detailed surgery can be performed accurately.

The operating pedal unit 12 includes a plurality of pedals for performing functions related to medical devices. The plurality of pedals include a coagulation pedal, a disconnect pedal, a camera pedal, and a clutch pedal. Further, the plurality of pedals are operated by the feet of the operator O.

The coagulation pedal can perform an operation of coagulating the surgical site using the electric surgical instrument 40. Specifically, when the coagulation pedal is operated, a voltage for coagulation is applied to the electrosurgical instrument 40 to coagulate the surgical site. The cutting pedal can be operated to cut the surgical site by using the electric surgical instrument 40. Specifically, when the cutting pedal is operated, a cutting voltage is applied to the electrosurgical instrument 40 to cut the surgical site.

The camera pedal is used to control the position and posture of the endoscope 50 that images the inside of the body cavity. Specifically, the camera pedal enables the operation by the operation handle 11 of the endoscope 50. That is, while the camera pedal is being pressed, the position and orientation of the endoscope 50 can be operated by the operation handle 11. For example, the endoscope 50 is operated by using both the left and right operation handles 11. Specifically, the endoscope 50 is rotated by rotating the left and right operation handles 11 around an intermediate point between the left and right operation handles 11. Further, by pushing the left and right operation handles 11 together, the endoscope 50 advances to the back. Further, by pulling both the left and right operation handles 11, the endoscope 50 returns to the front. Further, by moving the left and right operation handles 11 up, down, left and right, the endoscope 50 moves up, down, left and right.

The clutch pedal is used when the operation connection between the robot arms 21a and 21b and the operation handle 11 is temporarily disconnected to stop the operation of the electrosurgical instrument 40. Specifically, while the clutch pedal is being operated, the robot arms 21a and 21b of the patient-side device 20 do not operate even if the operation handle 11 is operated. For example, when the operation handle 11 comes near the end of the movable range by the operation, the operation connection may be temporarily disconnected and the operation handle 11 may be returned to the vicinity of the center position by operating the clutch pedal. it can. Then, when the operation of the clutch pedal is stopped, the robot arms 21a and 21b and the operation handle 11 are reconnected, and the operation of the operation handle 11 can be resumed near the center.

The display unit 13 can display an image captured by the endoscope 50. The display unit 13 includes a scope type display unit or a non-scope type display unit. The scope type display unit is, for example, a viewing type display unit. Further, the non-scope type display unit is a concept including an open type display unit having a flat screen which is not a type of looking into the display of a normal personal computer.

When the scope type display unit is attached, the 3D image captured by the endoscope 50 attached to the robot arm 21b of the patient side device 20 is displayed. Even when the non-scope type display unit is attached, the 3D image captured by the endoscope 50 provided in the patient side device 20 is displayed. When the non-scope type display unit is attached, the 2D image captured by the endoscope 50 provided in the patient side device 20 may be displayed.

As shown in FIG. 2, the control device 14 includes, for example, a control unit 141 having a computing unit such as a CPU, a storage unit 142 having a memory such as a ROM and a RAM, and an image control unit 143. The control device 14 may be composed of a single control device for centralized control, or may be composed of a plurality of control devices for distributed control in cooperation with each other. The control unit 141 is an operation mode command to be executed by the robot arm 21a according to the switching state of the operation pedal unit 12, or the operation mode command input by the operation handle 11 or by the endoscope 50. Determine if it is an operation mode command to be executed. Then, when the control unit 141 determines that the operation mode command input to the operation handle 11 is an operation mode command to be executed by the electrosurgical instrument 40, the control unit 141 transmits the operation mode command to the robot arm 21a. As a result, the robot arm 21a is driven, and the operation of the electrosurgical instrument 40 attached to the robot arm 21a is controlled by this drive.

Further, when the control unit 141 determines that the operation mode command input to the operation handle 11 is an operation mode command to be executed by the endoscope 50, the control unit 141 transmits the operation mode command to the robot arm 21b. As a result, the robot arm 21b is driven, and the operation of the endoscope 50 attached to the robot arm 21b is controlled by this drive.

For example, the storage unit 142 stores control programs according to the type of the electric surgical instrument 40, and the control unit 141 reads out these control programs according to the type of the attached electric surgical instrument 40 to perform remote operation. The operation commands of the operation handle 11 and / or the operation pedal unit 12 of the device 10 can be made to operate in accordance with the individual electric surgical instruments 40.

The image control unit 143 transmits the image acquired by the endoscope 50 to the display unit 13. The image control unit 143 performs image processing correction processing as necessary.

(Structure of surgical instruments, adapters, drapes and robot arms)
The configuration of the electrosurgical instrument 40, the adapter 60, the drape 70, and the robot arm 21a according to the first embodiment will be described with reference to FIGS. 3 to 5.

As shown in FIGS. 3 to 5, the electrosurgical instrument 40 is removably connected to the robot arm 21a via an adapter 60. The adapter 60 is arranged between the drive unit 200 described later of the robot arm 21a and the electrosurgical instrument 40. The adapter 60 is a drape adapter for holding the drape 70 and is replaced by the user at each operation. As a result, the drape 70 can be held by using the adapter 60. The drape 70 is a drape for covering the robot arm 21a and has been sterilized. The adapter 60 is configured to sandwich the drape 70 with the robot arm 21a.

The electrosurgical instrument 40 is connected by attaching the connecting portion 40a, which is the mounting surface of the housing 43 arranged on the Z2 direction side, to the adapter 60. The connecting portion 40a is provided on the proximal end side (Y2 direction side) of the shaft 42, and is attached to and connected to the robot arm 21a via the adapter 60. Further, the adapter 60 is connected by attaching the electrosurgical instrument 40 to the connection portion 60a which is the attachment surface arranged on the Z1 direction side. Further, the adapter 60 is connected by attaching the connecting portion 60b, which is an attachment surface arranged on the Z2 direction side, to the driving portion 200 of the robot arm 21a. Further, the drive unit 200 of the robot arm 21a is connected by attaching the adapter 60 to the connection unit 21c which is an attachment surface arranged on the Z1 direction side.

The robot arm 21a is covered by the drape 70 because it is used in a clean area. Here, in the operating room, a clean operation is performed in order to prevent the incised portion and the medical device from being contaminated by pathogens, foreign substances, and the like. In this cleanup operation, a clean area and a contaminated area other than the clean area are set. The surgical site is located in a clean area. Members of the surgery team, including Operator O, should take care to place only sterilized objects in the clean area during surgery, and if moving objects located in the contaminated area to the clean area, this Sterilize the object. Similarly, when a member of the surgical team, including Operator O, places his hand in a contaminated area, the hand is sterilized before it comes into direct contact with an object located in a clean area. Instruments used in clean areas are sterilized or covered with a sterilized drape 70.

The drape 70 includes a main body portion 71 that covers the robot arm 21a, and a mounting portion 72 that is sandwiched between the drive portion 200 of the robot arm 21a and the adapter 60. The main body 71 is made of a flexible film member formed in a film shape. The flexible film member is made of a resin material such as thermoplastic polyurethane or polyethylene. The main body 71 is provided with an opening so that the drive unit 200 of the robot arm 21a and the adapter 60 can be engaged with each other. The opening of the main body 71 is provided with a mounting portion 72 so as to close the opening. The mounting portion 72 is made of a resin molded member. The resin molding member is made of a resin material such as polyethylene terephthalate. The mounting portion 72 is formed to be harder (harder to bend) than the main body portion 71. The mounting portion 72 is provided with an opening so that the driving portion 200 of the robot arm 21a and the adapter 60 can be engaged with each other. The opening of the mounting portion 72 may be provided so as to correspond to a portion where the driving portion 200 of the robot arm 21a and the adapter 60 are engaged with each other. Further, a plurality of openings of the mounting portion 72 may be provided so as to correspond to a plurality of engaging portions of the driving portion 200 of the robot arm 21a and the adapter 60.

The electrosurgical instrument 40 includes a plurality (four) driven members 44 (see FIG. 5) provided in the housing 43 and rotatably provided about a rotation axis extending in the Z direction. The plurality of driven members 44 are provided to operate (drive) the end effector 41. For example, the driven member 44 is connected to the end effector 41 by an elongated element (not shown) such as a wire or a cable inserted into the shaft 42. As a result, the wire is driven according to the rotation of the driven member 44, and the end effector 41 is operated (driven) according to the drive of the wire. Further, for example, the driven member 44 is connected to the shaft 42 via a gear (not shown). As a result, the shaft 42 is rotated according to the rotation of the driven member 44, and the end effector 41 is rotated according to the rotation of the shaft 42.

The driven member 44 includes a fitting convex portion 441 that fits with the drive transmission member 62 described later of the adapter 60 in order to transmit the driving force from the drive unit 200 of the robot arm 21a. The fitting convex portion 441 is provided so as to project from the surface of the driven member 44 on the Z2 direction side toward the adapter 60 side (Z2 direction side).

The adapter 60 includes an adapter main body 61 and a plurality (four) drive transmission members 62 rotatably held by the adapter main body 61 about a rotation axis extending in the Z direction. The adapter main body 61 includes a plurality (four) through holes 611 penetrating in the Z direction. A drive transmission member 62 is rotatably arranged about the rotation axis in each of the plurality of through holes 611. A plurality (four) of the drive transmission members 62 are provided so as to correspond to the plurality (four) of the driven members 44 of the electrosurgical instrument 40. The drive transmission member 62 is configured to transmit the driving force from the robot arm 21a to the driven member 44 of the electrosurgical instrument 40. The drive transmission member 62 includes a fitting recess 621 (see FIG. 4) that fits with the fitting protrusion 441 of the driven member 44 of the electrosurgical instrument 40. The fitting recess 621 faces the electrosurgical instrument 40 side (Z1 direction side) of the drive transmission member 62, and faces the side opposite to the electrosurgical instrument 40 side (Z2 direction side) from the surface of the drive transmission member 62 on the Z1 direction side. It is formed so as to be dented.

Further, the drive transmission member 62 includes a fitting recess 622 (see FIG. 5) that fits with the fitting convex portion 201b of the drive member 201 described later in the drive portion 200 of the robot arm 21a. The fitting recess 622 is recessed on the robot arm 21a side (Z2 direction side) of the drive transmission member 62 from the surface of the drive transmission member 62 on the Z2 direction side toward the side opposite to the robot arm 21a side (Z1 direction side). It is formed so as to be.

The robot arm 21a includes a drive unit 200 for driving the driven member 44 of the electrosurgical instrument 40. The drive unit 200 generates a driving force applied to the driven member 44 of the electrosurgical instrument 40. Specifically, the drive unit 200 includes a plurality (four) drive members 201 provided so as to correspond to the plurality of driven members 44 of the electrosurgical instrument 40. The drive member 201 has an actuator 201a including a motor that is a drive source, and a fitting convex portion 201b that is rotated about a rotation axis extending in the Z direction by the actuator 201a. The fitting convex portion 201b is provided so as to project from the surface of the drive member 201 on the Z1 direction side toward the adapter 60 side (Z1 direction side).

(Structure related to the cover of electric surgical instruments)
The configuration of the cover 46 of the electrosurgical instrument 40 will be described with reference to FIGS. 6 to 8.

As shown in FIGS. 6A and 6B, the end effector 41 is provided on the distal end side of the shaft 42 via the wrist structure 45. The wrist structure 45 is a structure provided at the distal end portion 42a of the shaft 42 for the posture change operation of the end effector 41. The wrist structure 45 is configured so that, for example, the end effector 41 can be rotated about three axes orthogonal to each other, the roll axis, the pitch axis, and the yaw axis.

The end effector 41 can be an electrocauterizing end effector that cauterizes the living tissue of patient P with heat generated by electrical energy. The electrocautery end effector may be, for example, a monopolar type (unipolar type) end effector, a bipolar type (bipolar type) end effector, or the like. High-frequency AC power can be supplied to the electrocautery end effector as electrical energy from a power supply source (not shown).

When the end effector 41 is an electrocautery end effector, a cover 46 (insulating cover) having electrical insulation is used in order to suppress the conduction of electrical energy to the biological tissue of the patient P at an unintended position. The cover 46 is removably connected to the shaft 42.

The cover 46 has a hollow elongated structure to accommodate the wrist structure 45 and at least a portion of the end effector 41. The cover 46 also contains an electrically insulating material. The electrical insulating material has sufficient flexibility to allow the end effector 41 to be operated (posture changed) while accommodating the wrist structure 45. As a result, the electrically insulating material does not interfere with the operation of the end effector 41, so that the operation of the end effector 41 can be smoothly performed. The electrically insulating material is an elastically deformable material such as rubber. The electrically insulating material is, for example, silicone (silicon rubber). This allows the cover 46 to be formed using silicone with flexibility, restoring force, high electrical insulation, and high temperature resistance. Specifically, it is preferable to use a silicone having an elongation rate of 100% or more and 1000% or less, preferably 500% or more and 900% or less of DIN53504-S1 from the viewpoint of smooth operation of the end effector 41. Further, it is preferable that the hardness (shore A) according to DIN 53505 is 50 or more and 70 or less from the viewpoint of the mountability of the cover 46 to the electric surgical instrument 40. Examples of such silicones include SILPURANR8020 / 60 and SILPURANR8030 / 60 manufactured by Asahi Kasei Wacker Silicone Co., Ltd.

Here, in the first embodiment, the cover 46 contains an X-ray contrast agent, which is a drug containing a material that does not easily transmit X-rays. As a result, the cover 46 containing the X-ray contrast medium can be detected by X-rays, so that even if the cover 46 is damaged during the operation and falls off from the electrosurgical instrument 40 in the patient P's body, the patient P's body You can find the cover 46 that has fallen off in your body.

The X-ray contrast agent may be, for example, a bismuth compound such as barium sulfate or bismuth oxide, lead oxide, calcium carbonate, potassium titanate, iodo compound or the like. Preferably, the X-ray contrast agent can be barium sulfate or the like having excellent electrical insulation. Further, the mixing ratio of the X-ray contrast agent can be, for example, 5% by weight or more and 50% by weight or less, preferably 15% by weight or more and 45% by weight or less, and more preferably 20% by weight. It can be% or more and 35% by weight or less. The X-ray contrast agent is uniformly dispersed from the tip end to the proximal end of the cover 46. The cover 46 is made of a material in which an X-ray contrast agent is uniformly mixed with an electrically insulating material.

As shown in FIGS. 6 to 8, the cover 46 has an opening 46b at the distal end 46a that is large enough for the end effector 41 to be inserted. The opening 46b has a substantially circular shape. Further, the cover 46 has an opening 46d having a size capable of inserting the end effector 41, the wrist structure 45, and the distal end side portion 42b of the shaft 42 into the proximal end portion 46c. The opening 46d has a substantially circular shape. The diameter of the opening 46d is larger than the diameter of the opening 46b.

The cover 46 is configured such that the end effector 41 is inserted through the opening 46d. As a result, the cover 46 is configured to be attached to the shaft 42. Specifically, the cover 46 is a portion of the end effector 41, the wrist structure 45 and the distal end side of the shaft 42 until the proximal end 46c having the opening 46d is stopped by the cover facing end 42c of the shaft 42. It is configured so that 42b is inserted. The cover 46 is configured to internally accommodate a portion of the end effector 41, the wrist structure 45 and the distal end side portion 42b of the shaft 42 while stopped by the cover facing end 42c of the shaft 42. There is. Further, in this state, the cover 46 is configured to expose a part (tip) of the end effector 41 to the outside through the opening 46b without accommodating the inside.

Further, the cover 46 has a front end side cover portion 461 and a base end side cover portion 462 connected (connected) to the front end side cover portion 461. The cover 46 is a molded product in which the distal end portion 46a to the proximal end portion 46c are integrally molded. That is, the front end side cover portion 461 and the base end side cover portion 462 are different parts of one member integrally formed by one molding. Further, both the front end side cover portion 461 and the proximal end side cover portion 462 contain an X-ray contrast medium. As a result, even if either of the front end side cover portion 461 and the proximal end side cover portion 462 of the cover 46 is damaged and falls off from the electrosurgical instrument 40 in the patient P's body during the operation, the patient P's body The cover 46 that has fallen off can be searched for by X-ray. The X-ray contrast agent is uniformly dispersed from the front end side cover portion 461 of the cover 46 to the proximal end side cover portion 462.

The tip side cover portion 461 has a tapered shape (truncated cone shape) in which the outer diameter gradually decreases toward the tip side (distal end side). The front end side cover portion 461 is configured to accommodate at least a part of the end effector 41. The distal end side cover portion 461 has a distal end portion 46a and an opening 46b of the cover 46 at the distal end (distal end). The base end side cover portion 462 has a cylindrical shape in which the outer diameter and the inner diameter are substantially constant. The base end side cover portion 462 is configured to accommodate at least the wrist structure 45 and the distal end side portion 42b of the shaft 42. The base end side cover portion 462 has a proximal end portion 46c and an opening 46d at the proximal end (proximal end).

[Second Embodiment]
In the second embodiment, the proximal end side cover portion 462 contains an electrically insulating material having a higher tear strength than the distal end side cover portion 461.

The tear strength of the electrically insulating material of the front end side cover portion 461 can be, for example, 30 kN / m or more and 60 kN / m or less. Further, the tear strength of the electrically insulating material of the base end side cover portion 462 can be, for example, 60 kN / m or more and 160 kN / m or less.

[Modification example]
It should be noted that the embodiments disclosed this time are exemplary in all respects and are not considered to be restrictive. The scope of the present invention is shown by the scope of claims rather than the description of the above-described embodiment, and further includes all modifications (modifications) within the meaning and scope equivalent to the scope of claims.

For example, in the first embodiment, the X-ray contrast agent is uniformly dispersed from the tip end to the proximal end of the cover, but the present invention is not limited to this. In the present invention, the X-ray contrast agent does not necessarily have to be uniformly dispersed from the tip end to the proximal end of the cover as long as the cover that has fallen off in the patient's body can be detected.

Further, in the first embodiment, an example in which the electrically insulating material of the cover is silicone (silicon rubber) is shown, but the present invention is not limited to this. In the present invention, the electrically insulating material of the cover may be polyurethane rubber other than silicone.

Further, in the first embodiment, an example is shown in which the front end side cover portion and the base end side cover portion of the cover are different parts of one member due to molding, but the present invention is not limited to this. In the present invention, the front end side cover portion and the base end side cover portion of the cover may be separate members. In this case, the front end side cover portion and the base end side cover portion of the cover may be integrally formed by joining such as heat welding.

Further, in the first embodiment, an example is shown in which the electrically insulating material of the front end side cover portion and the electrically insulating material of the proximal end side cover portion are the same material, but the present invention is not limited to this. In the present invention, the electrically insulating material of the front end side cover portion and the electrically insulating material of the proximal end side cover portion may be different materials from each other. Further, in the case of the second embodiment, the base end side cover portion may contain an electrically insulating material of a different type from the electrically insulating material of the tip end side cover portion, which has a higher tear strength than the tip end side cover portion. ..

21a: Robot arm, 40: Electric surgical instrument, 40a: Connection part, 41: End effector, 42: Shaft, 45: Wrist structure, 46: Cover, 46b: Opening, 100: Robot surgery system, 461: Tip side cover part , 462: Base end side cover

Claims (6)

An electrical surgical instrument that is detachably connected to the robot arm of a robotic surgery system.
With the shaft
An end effector provided on the distal end side of the shaft via a wrist structure,
A connection portion provided on the proximal end side of the shaft and connected to the robot arm,
An electrosurgical instrument having a hollow elongated structure for accommodating the wrist structure and comprising a cover containing an electrically insulating material and an X-ray contrast agent. The cover has an opening at the distal end sized for the end effector to be inserted.
The electrosurgical instrument of claim 1, wherein the electrically insulating material has the flexibility to allow the end effector to be operated while accommodating the wrist structure. The electrosurgical instrument according to claim 1 or 2, wherein the electrically insulating material is silicone. The cover has a tip side cover portion and a proximal end side cover portion connected to the tip end side cover portion.
The electrosurgical instrument according to any one of claims 1 to 3, wherein the base end side cover portion includes an electrically insulating material having a higher tear strength than the tip end side cover portion. The electrosurgical instrument according to claim 4, wherein both the distal end side cover portion and the proximal end side cover portion contain an X-ray contrast medium. Detachably connected to the robot arm of a robotic surgery system, a shaft, an end effector provided on the distal end side of the shaft via a wrist structure, and a proximal end side of the shaft. A cover for an electrosurgical instrument that has a connection to the robot arm.
A cover having a hollow elongated structure for accommodating the wrist structure and containing an electrically insulating material and an X-ray contrast agent.

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